Maintenance of Drinking Reductions to Lower Risk Over Time
Recently, we summarized a research report by Witkiewitz et al on the association between reduction of alcohol consumption by risk levels defined by the World Health Organization* and quality of life. Whether non-abstinent reductions are stable over time remained an open question. To study the maintenance over time of 1- and 2-level reductions and associations with functioning, researchers used data from COMBINE study participants who received treatment for DSM-IV alcohol dependence.
- 1- and 2-level reductions at the end of treatment (week 16 of the COMBINE trial) were significantly associated with WHO risk level reductions at 1 year (odds ratio [OR], 10.25 for at least a 1-level reduction; OR, 9.40 for at least a 2-level reduction).
- Among participants with a 1-level reduction at the end of treatment, 86% reported at least the same reduction at 1 year.
- Among those with a 2-level reduction at the end of treatment, 78% reported at least the same reduction at 1 year.
- Reductions over time were associated with fewer alcohol-related consequences and with lower systolic blood pressure and liver tests.
* Low (1–40g ethanol/day for men, 1–20g/day for women); medium (41–60g/day for men, 21–40g/day for women); high (61–100g/day for men, 41–60g/day for women); and very high (≥101g/day for men, ≥61g/day for women).
Comments: In this cohort of participants in a trial of treatment for alcohol use disorder, reductions in risk levels as defined by the WHO were stable at 1 year. Reductions in risk levels were associated with better functioning. This study adds valuable information on the maintenance over time of non-abstinent drinking reductions and further supports its use as a clinical goal.
Nicolas Bertholet, MD, MSc
Reference: Witkiewitz K, Falk DE, Litten RZ, et al. Maintenance of World Health Organization risk drinking level reductions and posttreatment functioning following a large alcohol use disorder clinical trial. Alcohol Clin Exp Res. 2019;43(5):979–987.